"I had so many life-changing decisions I had to make without support": a qualitative analysis of women's pregnant and postpartum experiences during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has posed profound challenges for pregnant patients and their families. Studies conducted early in the pandemic found that pregnant individuals reported increased mental health concerns in response to pandemic-related stress. Many obstetric practices changed their healthcare delivery models, further impacting the experiences of pregnant patients. We conducted a survey study to explore the ways in which COVID-19 impacted the lives of pregnant and newly postpartum people. METHODS: A mixed-methods survey was distributed to all patients ≥18 years old who were pregnant between January 1st, 2020 - April 28, 2021 in a large Midwest health system. Open-ended survey responses were analyzed for common themes using standard qualitative methodology. RESULTS: Among the 1182 survey respondents, 647 women provided an open-ended response. Of these, 77% were in the postpartum period. The majority of respondents identified as white, were partnered or married, and owned their own home. Respondents reported feeling greater uncertainty, social isolation, as though they had limited social and practical support, and negative mental health effects as a result of the pandemic. Many cited sudden or arbitrary changes to their medical care as a contributing factor. Though in the minority, some respondents also reported benefits from the changes to daily life, including perceived improvements to medical care, better work-life balance, and opportunities for new perspectives. CONCLUSIONS: This large qualitative dataset provides insight into how healthcare policy and lifestyle changes impacted pregnant and postpartum people. Respondents expressed similar levels of uncertainty and mental health concerns compared to other cohorts but less overall positivity. Our findings suggest greater attention be given to the impact of pandemic-related stress on pregnant and postpartum women. As the pandemic continues, these data identify areas where investment in additional support may have the greatest impact.

Impact of the COVID-19 Pandemic on Obstetricians/Gynecologists.

OBJECTIVE: To assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on obstetricians/gynecologists (OB/GYNs). PARTICIPANTS AND METHODS: A 49-item survey was distributed to OB/GYNs through the websites and electronic mailing lists of professional OB/GYN organizations. The survey was open from June 22, 2020, through November 22, 2020. Of the 122 initiated surveys, 89 were completed (73.0% completion rate); 72 respondents answered at least one open-ended question and were included for qualitative analysis. RESULTS: Respondents reported policy changes, limited personal protective equipment availability, patient compliance with safety protocols and personal protective equipment use, staff shortages, and concerns about COVID-19 exposure as primary stressors related to the pandemic. Respondents felt that the pandemic had a negative professional impact on their relationships with patients and colleagues. Workplace and pandemic stressors resulted in feelings of anxiety and frustration; physical effects were also reported. Some respondents indicated that they were considering early retirement or leaving the profession as a result of the pandemic, which suggests that OB/GYNs may be at increased risk for burnout. CONCLUSION: The COVID-19 pandemic will have important long-term effects on OB/GYN well-being and workforce retention. Proactive support for OB/GYNs is needed to combat burnout and counteract workforce attrition. Implementing peer support programs that promote healthy emotional processing following adverse events may mitigate these feelings and reduce OB/GYN burnout.